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Nutrients
Volume 17
Issue 20
10.3390/nu17203272
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

Vitamin B12 in Cancer Patients: Clinical Insights into Deficiency, Excess, Diagnosis, and Management

by
Małgorzata Osmola
1,*,
Martyna Tyszka
2,
Adam Jirka
3,
Olga Ciepiela
4,
Aleksandra Kapała
5,
Marco Vincenzo Lenti
6,7 and
Tamara Matysiak-Budnik
3,8
1
Maria Sklodowska-Curie Medical Academy in Warsaw, 03-411 Warsaw, Poland
2
Department of Clinical Oncology, Medical University of Warsaw, 02-091 Warsaw, Poland
3
IMAD, Hepato-Gastroenterology & Digestive Oncology, University Hospital of Nantes, 44-000 Nantes, France
4
Department of Laboratory Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
5
Department of Oncology Diagnostics, Cardio-Oncology and Palliative Medicine, Maria Skłodowska-Curie National Research Institute of Oncology, 02-871 Warsaw, Poland
6
Department of Internal Medicine and Medical Therapeutics, University of Pavia, 27-100 Pavia, Italy
7
First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, 27-100 Pavia, Italy
8
CHU de Nantes, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, Institut de Transplantation Urologie-Néphrologie, Nantes Université, 44-000 Nantes, France
*
Author to whom correspondence should be addressed.
Nutrients 2025, 17(20), 3272; https://doi.org/10.3390/nu17203272
Submission received: 16 September 2025 / Revised: 10 October 2025 / Accepted: 16 October 2025 / Published: 17 October 2025
(This article belongs to the Section Clinical Nutrition)
Review Reports Versions Notes

Abstract

Vitamin B12 (cobalamin) is a critical micronutrient involved in hematopoiesis and neurological function. Its deficiency, commonly presenting with anemia and neurological symptoms, is particularly relevant in oncology. While anemia affects up to 60% of cancer patients, the contribution of vitamin B12 deficiency to cancer-related anemia remains underexplored. Additionally, cobalamin-related neuropathy manifests or exacerbates existing chemotherapy-induced peripheral neuropathy (CIPN), a serious side effect of chemotherapy. Prevalence estimates in cancer populations range widely (6–48%), with higher rates in elderly and gastrointestinal cancer patients. This review summarizes current evidence on the prevalence and implications of both vitamin B12 deficiency and excess in patients with solid tumors. It discusses laboratory markers (such as serum vitamin B12, holotranscobalamin, methylmalonic acid, and homocysteine) that could improve diagnostic accuracy in oncology settings. Additionally, it evaluates supplementation strategies and discusses its role in mitigating CIPN. Additionally, it addresses B12′s emerging immunological role in cancer therapy.
Keywords: vitamin B12 deficiency in cancer; hypercobalaminemia; vitamin B12 supplementation in cancer; homocysteinemia in cancer; methymalonic acid; vitamin B12 in CIPN vitamin B12 deficiency in cancer; hypercobalaminemia; vitamin B12 supplementation in cancer; homocysteinemia in cancer; methymalonic acid; vitamin B12 in CIPN

Share and Cite

MDPI and ACS Style

Osmola, M.; Tyszka, M.; Jirka, A.; Ciepiela, O.; Kapała, A.; Lenti, M.V.; Matysiak-Budnik, T. Vitamin B12 in Cancer Patients: Clinical Insights into Deficiency, Excess, Diagnosis, and Management. Nutrients 2025, 17, 3272. https://doi.org/10.3390/nu17203272

AMA Style

Osmola M, Tyszka M, Jirka A, Ciepiela O, Kapała A, Lenti MV, Matysiak-Budnik T. Vitamin B12 in Cancer Patients: Clinical Insights into Deficiency, Excess, Diagnosis, and Management. Nutrients. 2025; 17(20):3272. https://doi.org/10.3390/nu17203272

Chicago/Turabian Style

Osmola, Małgorzata, Martyna Tyszka, Adam Jirka, Olga Ciepiela, Aleksandra Kapała, Marco Vincenzo Lenti, and Tamara Matysiak-Budnik. 2025. "Vitamin B12 in Cancer Patients: Clinical Insights into Deficiency, Excess, Diagnosis, and Management" Nutrients 17, no. 20: 3272. https://doi.org/10.3390/nu17203272

APA Style

Osmola, M., Tyszka, M., Jirka, A., Ciepiela, O., Kapała, A., Lenti, M. V., & Matysiak-Budnik, T. (2025). Vitamin B12 in Cancer Patients: Clinical Insights into Deficiency, Excess, Diagnosis, and Management. Nutrients, 17(20), 3272. https://doi.org/10.3390/nu17203272

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